摘要
目的 探讨基于MRI征象、免疫组化及免疫炎症指标预测乳腺癌腋窝淋巴结转移的价值.方法 回顾性收集 2021 年 1 月至 2022 年 10 月就诊于右江民族医学院附属医院的 57 例乳腺癌患者的临床及影像资料,根据术后淋巴结活检结果分为腋窝淋巴结转移组(简称转移组)及非腋窝淋巴结转移组(简称非转移组),分别对比两组术前MRI征象、临床病理特征及免疫炎症指标的差异,采用Spearman秩相关分析术前MRI征象、病理免疫组化及免疫炎症指标与乳腺癌腋窝淋巴结转移的相关性,绘制受试者工作特征(ROC)曲线并比较其诊断效能.结果 总共收集57 例患者,其中转移组 24 例,非转移组 33 例,转移组的年龄、淋巴结短径、长短径比、肿瘤长径、肿瘤强化方式、Ki-67的表达、NLR、PLR与非转移组比较差异有统计学意义(P<0.05 或 0.01),相关分析显示,淋巴结短径、肿瘤长径、肿瘤强化方式及Ki-67 与腋窝淋巴结转移呈正相关(r分别为 0.515、0545、0.377、0.484,P<0.05),长短径比与腋窝淋巴转移呈负相关(r=-0.699,P<0.05);单因素分析显示年龄、淋巴结短径、长短径比、肿瘤长径、肿瘤强化方式、Ki-67、NLR、PLR的曲线下面积(AUC)分别为 0.540、0.801、0.908、0.818、0.680、0.741、0.590、0.605.结论 MRI征象、免疫组化及免疫炎症指标对判断乳腺癌患者是否发生淋巴结转移有重要的预测价值,可以为临床治疗方案的选择提供证据.
Abstract
Objective To investigate the value of MRI signs,immunohistochemistry and immunoinflammatory indicators in predicting axillary lymph node metastasis of breast cancer.Methods Clinical and imaging data of 57 patients with breast cancer admitted to Affiliated Hospital of Youjiang Medical University for Nationalities from January 2021 to October 2022 were retrospectively collected.They were divided into axillary lymph node metastasis group(referred to as metastasis group)and non-axillary lymph node metastasis group(referred to as non-metastasis group)according to postoperative lymph node bi-opsy results.Preoperative MRI signs,clinicopathological features and immunoinflammatory indicators of the two groups were compared,respectively.Spearman correlation was used to analyze the correlation between preoperative MRI signs,pathologi-cal immunohistochemistry and immunoinflammatory indicators and axillary lymph node metastasis of breast cancer,and re-ceiver operating characteristic(ROC)curve was drawn,and diagnostic efficacy was compared.Results A total of 57 pa-tients were collected,including 24 patients in the metastasis group and 33 patients in the non-metastasis group.There were statistically significant differences in age,lymph node short diameter,ratio of length to diameter,tumor long diameter,tumor enhancement mode,Ki-67 expression,NLR,PLR between the metastasis group and the non-metastasis group(P<0.05 or 0.01).Correlation analysis showed that,lymph node short diameter,tumor long diameter,tumor enhancement mode and Ki-67 were positively correlated with axillary lymph node metastasis(r was 0.515,0545,0.377,0.484,respectively,P<0.05),while the ratio of length to diameter was negatively correlated with axillary lymph node metastasis(r=-0.699,P<0.05).Univariate analysis showed that,the area under the curve(AUC)of single factor age,lymph node short diameter,ratio of length to diameter,tumor length diameter,tumor enhancement mode,Ki-67,NLR and PLR were 0.540,0.801,0.908,0.818,0.680,0.741,0.590 and 0.605,respectively.Conclusion MRI signs,immunohistochemistry and im-munoinflammatory indicators have important predictive value in determining whether lymph node metastasis is occurring in breast cancer patients,and can provide evidence for the selection of clinical treatment.
维普
万方数据